Ruminations by a non-academic general surgeon from the heart of the rust belt.

Tuesday, October 6, 2009

Appy Condoms

Dr Waxman's group in Santa Barbara, California has a paper out in Archives this week which makes a strong argument for the Alexis wound retractor when doing an open appendectomy. I use a wound retractor when doing laparoscopic colon resections but I had never heard of anyone using one for an appy. The paper is decent; it's a randomized controlled trial (total of 100 patients or so) comparing wound infection rates with and without the Alexis device. None of the wound-condom patients developed infections while 15% of the cases in the au naturel group were complicated by superficial wound infections.

The device only costs 20 bucks so you're not going to bankrupt the healthcare system by using it. But it just seems a little overwrought to me. Take out the damn appendix laparoscopically if you're worried about wound infections. Much more elegant anyway...

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